Factors affecting treatment practices of patent medicine vendors for malaria in under-five children: implications for malaria control in Nigeria

Background: Patent medicine vendors (PMVs) are the most common source of antimalarial drugs and treatment for majority of Nigerians. The quality of their practice could have implications for malaria control. This study sought to explore the factors influencing the malaria treatment practices of PMVs for under-five children in Akwa Ibom State. Methods: A cross-sectional survey using an interviewer-administered questionnaire was conducted among 176 PMVs selected by simple random sampling from two local government areas (LGAs). In addition, four focus group discussions (FGD) were conducted to generate qualitative data. Quantitative data was analysed using SPSS version 20 while content analysis was done on the qualitative data. Results: Artemisinin Combination Therapy (ACT) was the most frequently recommended antimalarial treatment by PMVs (75.6%) for children as against chloroquine (17%) and Sulphadoxine/Pyrimethamine (2.8%). However, only 39.2% of PMVs recommended the appropriate antimalarial treatment (ACTs at the right dose for age), while 71% recommended referral for severe malaria. Factors found to be associated with appropriate management of malaria from quantitative analysis included Educational qualification, attending malaria training and their knowledge of malaria. The FGDs showed that severity of child's illness, parents/caregivers drug request and perceived ability of the parents/caregiver to afford the drugs influenced PMVs malaria treatment practices. Conclusion: Knowledge of malaria, severity of child's illness and parents' drug request influenced the treatment practices of PMVs. Training PMVs on appropriate malaria management and community health education/sensitization to leverage on the influence of client-demand on ACT use is recommended to improve PMVs treatment practice

Prevalence and Risk Factors of Low Back Pain among Workers in a Health Facility in South–South Nigeria.

Background: Low back pain (LBP) has been documented to be a common occupational health problem among health care workers. A cross sectional study was carried out in a health facility in South – South Nigeria to determine the prevalence and risk factors of low back pain among the workers. Materials and Methods: Data was collected using a self designed, interviewer assisted, semi-structured questionnaire. Information obtained included socio-demographic characteristics, work history of respondents, prevalence and factors predisposing to low back pain. The tool was administered during the different shifts of the health workers. Frequencies were calculated and Fishers exact test was used to test the significance of association between different variables. Level of significance was set at 0.05. Results: A total of 50 out of 53 workers participated in the study. The mean age of the respondents was 36.59±8.6 years with a male to female ratio of 2:3. The overall prevalence of LBP over the preceding 12 months was 28%, while the prevalence among males was 35% and females, 23.3%, respectively. The proportion of those with LBP among the doctors, pharmacists and nurses was 33.3% each. No history of back pain was recorded among the administrative staff. Prolonged standing/sitting (25.0%), age above 35 years (38.9%), being overweight or obese (50.0%), lifting of heavy objects (35.7%) and frequent stooping (33.3%) were common risk factors associated with LBP. The associations were however not statistically significant (p>0.05). Up to 42.8% of those with LBP had sleep disturbance and 21.4% needed to obtain sick leave as a result of the pain. Conclusion: LBP was a common problem among staff in the health facility. Also, prolonged standing/ sitting, being overweight or obese, and lifting of heavy objects were among risk factors reported by those with LBP. Use of ergonomically designed chairs and equipments in the workplace, better lifting techniques and encouragement of mobility among the workers may help reduce the risk of LBP and thus improve workers’ productivity and wellbeing.